Screening for breast cancer

Screening for breast cancer

Screening for breast cancer involves a highly sensitive diagnostic test to detect the disease in either the preclinical detectable phase or a high-risk precancerous lesion. In most high-income countries population-based mammographic screening achieves very high (90–95%) long-term survival in patients with screen-detected tumours. In the UK, all women aged between 50 and 70 years are invited for mammographic screening every 3 /uni00A0 years. In low- and middle-income countries, population-based mammographic screening is not available. In some Asian countries clinical breast examination by a trained healthcare professional along with increasing breast health awareness by breast self-examination is being encouraged as a mode of screening. In India, national screening involves multidisease screening for cancer of the mouth, breast and cervix for all women aged 30–65 years. Clinical breast examination can detect the disease in the early stages while breast self-examination can help women become aware of breast health, detect breast changes and report to the healthcare facility early . Patients with a suspicious lesion on mammogram are invited for biopsy under image guidance. In small or impalpa ble lesions a metal clip may be inserted at the site of the lesion. If a carcinoma is found on histology , the metal clip facilitates insertion of a hook wire with its tip near the centre of the lesion to facilitate wire-guided excision. Further therapy is based on histolog y of the excised specimen after discussion in the MDT . The authors are grateful to Professors Smriti Hari and Maneesh Singhal from the All India Institute of Medical Sciences (AIIMS), New Delhi, India, for their assistance in providing illustrations used in the chapter, and to Dr Shivangi Saha of AIIMS, New Delhi, for her contribution to the breast reconstruction section and illustrations. Professor V Seenu of AIIMS critically reappraised the section on sentinel node biopsy . Professor Sandeep Kumar provided insight and critical reappraisal of the section on ANDI and benign breast disease. Dr Deepti Singh helped in the section on mastitis. Professor Manoj Kumar Singh and the team of artists at Virtual Skills Laboratory , AIIMS, designed most of the illustrations and videos for this chapter.

Figure 58.40 Angiosarcoma of the breast in a young woman.